Structuring healthcare as an insurance doesn't work because pretty much everyone needs it at some point. It needs to be structured like a tax, because the rate at which you pay in has no correspondance with how much you need to get back out, but in aggregate the total sum paid matches the total care provided. That's why the successful healthcare systems in the world are typically single payer systems. However, such systems are politically untenable in the U.S. and so you get obamacare. I'm sure if it was within the overton window of acceptable political thought obamacare would have been a single payer system.
> Structuring healthcare as an insurance doesn't work because pretty much everyone needs it at some point. It needs to be structured like a tax, because the rate at which you pay in has no correspondance with how much you need to get back out, but in aggregate the total sum paid matches the total care provided.
you've just outlined a money-losing system run by the government.
the reason private health insurance systems fail is not merely because everyone needs it at some point. it's because everyone uses much more of it than they've paid for with their premiums. (which is why, pre-Obamacare, insurance companies used to reject applicants with pre-existing conditions and why they put lifetime caps on benefits paid.)
but a government run single-payer system is not magic. the extra cash must come from somewhere.
one way a single-payer system could obtain the additional funds needed is by taking cash from some other government source (which is exactly what Obamacare does when it provides refundable tax credits to help low income people pay their otherwise unaffordable health insurance premiums.) but there's no end to the amount of money that could require.
another thing the government can do is limit services to patients, i.e. take a certain amount of decision making authority, by law, away from individuals, especially old individuals who are very sick. ("i'm sorry, but we're not paying for that new chemotherapy. it's hospice care for you.")
in addition, a single-payer system can also uniformly limit the prices health care providers, pharma companies, hospitals, etc can charge. (i.e take some decision making authority away from that sector of the economy, again, by law.)
I live in a single payer system country and it's nothing like what you describe.
First, how it is paid. It's text book socialism. People pay into it based on ability and receive benefits based on need. It doesn't run at a loss.
Second, the level of care. Basically the government puts a lower bound on health care and uses taxation to do it. You're guaranteed a basic level of care regardless of your situation. You can opt for private insurance that stacks on top of that. A basic level of treatment is covered by the government, but anything experimental or exorbitant you will likely have to pay yourself, unless you have the aforementioned gold-plated insurance. Insurance is much cheaper because it only needs to cover unusual care, but of course I do pay a lot of taxes.
It's not different from a private system, because you can't receive unlimited care, but unlike a private system you're always guaranteed a minimum care.
